Healthcare and Education: Innovation for Sustained Cooperation and Improvement

Maldives is one nation in South Asia where government school education is held in high esteem. So is the case with government hospitals. They are sensitive political and election issues as well

In a nation with a population of 350,000, Maldives has close to another hundred thousand expatriates oiling and toiling the nation’s economic wheels with them. Over a quarter of those expatriates are Indians, coming from across the country.

When resort tourism opened up the Maldivian economy to itself and job seekers from the neighbourhood in the late seventies, the services sector came on the top. It still is. Yet, when the government began channelling tourism revenue for the betterment of the local population, health and education became top priorities. With tourism came banking and other sections of the white collar services sectors.

It is not just about Maldives providing jobs for expatriates from the neighbourhood. It worked even more on the reverse. Doctors and nurses, teachers and office executives, including bank executives, worked with Maldivians to make the ‘Maldivian Dream’ happen. Today, there is possibly no area of public life in the country, barring direct politics and public administration, where expatriate workers, particularly from India, do not have a hand.

Historically and traditionally, Sri Lanka has made a long and cherished contribution in the contemporary context in terms of supporting Maldives in health and education. So has India. When it came to teachers, doctors and nurses from other countries going to Maldives to work in these sectors, naturally Sri Lankans topped the list, initially.

As Maldives moved on the value chain, so did the early Sri Lankan expatriates. As organised, government funded training programmes for the semi skilled and unskilled labour made West Asia and Europe more attractive for Sri Lankans, personnel from southern India soon filled in the emerging vacuum/vacancies. There was a time when Indians, particularly from southern Tamil Nadu and Kerala, not to leave out counterparts from their immediate neighbours, filled most vacancies in these sectors.

Expanding Labour Sourcing

Today, labour sourcing has expanded to include job seekers from across India. They come from as far away as Sikkim and Arunachal Pradesh in the ‘faraway’ North-East, and Rajasthan and Himachal Pradesh in the ‘distant’ North-West. Those from the eastern States of Odisha, West Bengal and Bihar are clearly visible during the Friday evening relaxation of expatriate workers in capital Male’s beachfront at the Independence Square.

The across-the-board decision a few years back of the Maldivian government to affect a 20 percent cut back on pay, owing to economic recession, made Maldives less attractive. By then, Maldives had become the cynosure of all eyes in South Asia, in particular. This meant that reports of political instability, economic recession and dollar crunch all added to the apprehensions of the average Indian job seeker.

Falling prey to unscrupulous job agencies and middlemen, the migrant labours now hope for some relief after the government’s tightening and rationalisation of procedures, to make them effective and labour friendly at the same time. Persistent Indian efforts also helped in the matter – with the result, more Indians continue to find Maldives an attractive job market. Like Sri Lankans before them, Indians now dominate the country’s skilled employee market.

Instant and Direct Benefit

With irritants of the past now removed, there is greater scope for bilateral cooperation between India and Maldives in the education and healthcare sectors. The average Maldivian youth’s desire to acquire appropriate education, particularly in the higher education sector, needs to be seen to be believed. So is the commitment of their parents, who have been sending their wards to ‘distant’ Male and other urban/population centres, where ‘O’ and ‘A’ Level Cambridge education is available. This has meant dislocating/re-locating families, lock, stock and barrel.

Maldives is one nation in South Asia where government school education is held in high esteem. So is the case with government hospitals. They are sensitive political and election issues as well. Successive governments have tried to do their best on these fronts. This has meant the need and scope for improving Indian inputs in these two sectors. The substantive Indian presence in these two sectors can be supportive and can act as a catalyst.

The opening up of the Maldivian economy to foreign investment, and the more recent government decision of setting up Special Economic Zones (SEZ) with foreign investment should also loosen the controls regimen and fast track decision making in other sectors. This could mean that Indian institutions offering higher education and speciality healthcare opportunities, now conducting ‘road-shows’ in Maldives, among others, could consider setting up institutions nearer to home for Maldivians to benefit from them, directly and almost instantly.

The reality of the situation would demand that any proposal for Indian higher education institutions and multi-speciality hospitals to come to Maldives in a big way cannot stop with incentives on the investment front that are otherwise applicable under the recently framed SEZ laws, rules and regulations. Speciality institutions, unlike commercial investments, have special requirements.

Investors in the manufacturing sector in the SEZs would want permission to re-export their products made in Maldives for marketing overseas. Given the relatively low population and availability of skilled employees (until constant retraining and skill upgradation make it possible), SEZ investors would also want to bring in the required personnel from overseas.

Medical Tourism Hub

Likewise, a high end healthcare institution, for instance, cannot stop with the government allotting a preferred island with connectivity, to set up a speciality hospital. Permission for non-Maldivians to get treated in a local speciality hospital in the midst of the serene atmosphere and clean air that the archipelago has to offer could make Maldives a ‘medical tourism hub’ – in its own and limited way.

As the experience of India and Sri Lanka in the neighbourhood has proved, it is not only Western and West Asian patients requiring super speciality healthcare who would flock to the ‘medical hub’ that Maldives can become. In some cases, they may be accompanied by family members, for whom tourism may be a standalone option, as well. And there can be no place like Maldives for a patient recovering to recuperate after undergoing a major surgery or other procedures.

This would, in turn, require attention to immigration laws and forex repatriation, where overseas doctors working in a Maldivian super speciality hospital would expect a less rigorous process and procedure. The government or a future investor could consider setting up a medical and/or nursing school in Maldives. The former, in particular, would require sanction for the promoter to enrol overseas students against dollar payment, if at all. Local laws relating to postmortem examination, cadaver transplant and organ replacement also might require attention.

Higher Education

What applies to medical education also is true of other areas of higher education, as far as Indian engagement in Maldives is concerned. While available school level education has always been based on the Western Cambridge model, those desiring higher education in varied fields will have to travel overseas to acquire those degrees. Ultimately, it also leads to brain drain, though for a long time the government has been meeting overseas educational expenses of deserving Maldivian students.

Arresting the trend will again require opportunities for the higher education sector, particularly in south India. Considering that in all sectors of higher education there will only be a few Maldivians equipped to join, at least in the early years, the institutions would make sense if, and only if, they are encouraged to also admit overseas students.

In turn, the government could ensure that higher education institutions, including those in the health education sector, earmark a certain number of seats for deserving local students. It would then be up to the Maldivian government to decide as to the kind of concessions that it may – or, may have to – provide local students in terms of the high fees for higher education, a part of which they now obtain for studying overseas.

Already, India and Maldives have worked together in the education and health sectors for a long time. To augment cooperation in the health sector in particular, the Indian armed forces have inducted their medical personnel to run a hospital for the uniformed personnel in Maldives, and also to conduct medical camps in some islands. India has also set up a school for the hospitality industry and a law school; the latter for the Maldives National University, a few years ago.

To ensure quality, the two nations can work together for teachers, doctors and nurses identified by the government in India, to work in Maldives, so as to ensure quality and regularity in tenure and turnover. Already, the Government of India provides scholarship for neighbourhood students, including those from Maldives, to study in higher education institutions in India of the latter’s choice. The number and quantum of scholarships, particularly for a nation like Maldives, should also be constantly reviewed and upgraded.

Together, all this can take bilateral cooperation in these sectors – and overall bilateral relations – to far higher levels than from the trickle of Maldivian students and patients requiring speciality and super speciality healthcare visiting Thiruvananthapuram and Bengaluru, among other south Indian destinations, long ago.

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